Emergency contraception (EC) refers to back-up methods for contraceptive emergencies which women can use within the first few days after unprotected intercourse to prevent an unwanted pregnancy. The WHO-recommended regimen for emergency contraception is 1.5 mg levonorgestrel as a single dose. According to WHO, emergency contraceptives are usually not suitable for regular use (WHO. Medical eligibility criteria for contraceptive use. Third edition. Geneva, 2004; WHO. Selected practice recommendations for contraceptive use. Second edition. Geneva, 2005).
Conventional oral contraceptive (OC) starting instructions require waiting until menses to begin the OC. When a woman requires birth control at an office visit occurring between menses, many physicians delay starting hormonal contraceptives. However delaying contraception may place women at risk of unintended pregnancy until following menses. For this reason, it was proposed taking hormonal birth control products immediately after an office visit, at any point in the menstrual cycle, according to a “Quick Start” method (Lesnewski and Prine, Am Fam Physician, 2006, 74:105-12; Westhoff et al, Contraception, 2002, 66(3):141-5).
One important role emergency contraception pills could play is to serve as a gateway to longer-term method use (Don Downing presentation on behalf of the SC Emergency Contraception initiative, Mar. 12-16, 2007). In an over-the counter (OTC) environment e.g. where EC pills are accessed at pharmacies or drugstores and not family planning clinics, this may be more difficult to implement since there is no required visit to a clinician. Programs have then been developed in order to propose regular contraception to women using EC (ECAfrique bulletin, January 2008 vol 5/1).